When we look at recent research, some patterns are fairly consistent: more girls and women have OCD compared to boys and men (in teenage and adult groups), men tend to develop symptoms at a younger age or have their worst symptoms younger, adult women are more likely to have contamination fears and worry about causing harm, and adult men are more likely to have disturbing religious or sexual thoughts. Men and women seem equally likely to respond well to treatment and to have additional mental health conditions, though the specific types of additional conditions might differ by gender. However, some studies have found no gender differences at all in how common OCD is, when it starts, or what symptoms people have. 

Summary of Research Findings

OCD is a complex and disabling condition that affects up to 3% of people (and even more if you include those with milder symptoms). Researchers think gender might be one reason why symptoms vary from person to person, since men and women seem to have different symptoms, different courses of illness, and different additional mental health problems. 

Wesleyan University

This article reviews recent research on gender differences in OCD, focusing on prevalence, course of illness, symptom presentation, comorbidity, and treatment response. It aims to reconcile gender disparities in research through their review to inform future directions for research. They concluded that gender may play a role in the onset, presentation, and impact of OCD symptoms, but more research is required to account for differences across studies.

Summary of “Epidemiological and Clinical Gender Differences in OCD”

Mathes, B.M., Morabito, D.M. & Schmidt, N.B. Epidemiological and Clinical Gender Differences in OCD. Curr Psychiatry Rep 21, 36 (2019). https://doi.org/10.1007/s11920-019-1015-2

Reference for “ Epidemiological and Clinical Gender Differences in OCD”

OCD affects approximately 1-3% of the population. In one of the biggest studies done in the USA, they found that 2.3% of adults had OCD at some point in their lives, and 1.2% had it in the past year. Other recent studies of both adults and teenagers have found similar numbers. These rates are fairly similar across different countries.

Prevalence of OCD

Usually, mild OCD symptoms start showing up in childhood, but the full disorder often doesn't develop until the teenage years or early twenties. Most people who develop OCD will have it for a long time, with symptoms getting better and worse over the years. One study found that mild symptoms typically started around age 16 and full OCD around age 19, though any kind of symptom usually first appeared around age 10. In that same study, about 37% of OCD cases and 29% of mild symptom cases had started by ages 19-20. Very few new cases developed after age 30, which shows that OCD usually begins by early adulthood and rarely starts later in life.

Course of Illness: OCD and Mild OCD Symptoms

There seem to be differences in what types of symptoms men and women have, but these differences might not show up in younger people. Recent studies of school-age children and teenagers found no differences between boys and girls in what types of symptoms they had, suggesting that gender differences might develop as people get older. However, in adults, women were much more likely to have fears about contamination and thoughts about hurting someone, while men were more likely to have disturbing religious or sexual thoughts.

OCD Symptom Dimension

Most people with OCD also have at least one other mental health condition. In one study of 382 people with OCD, about 55% had another current mental health diagnosis, and about 78% had another diagnosis at some point in their lives. The most common additional problems were other anxiety disorders, depression, and related conditions like hoarding or body dysmorphic disorder. This pattern was confirmed in another study of OCD patients.

OCD Comorbidity 

The best treatment for OCD is a type of therapy called cognitive behavioral therapy (CBT) that includes "exposure and response prevention" (ERP), where people gradually face their fears and learn not to do their compulsive behaviors. Often, but not always, people also take medication – usually antidepressants (SSRIs or SNRIs). These medications can help boost the effects of therapy, though studies show mixed results about how well both therapy and medication work.

OCD Treatment Response

Research Conclusions

There are probably several reasons why different studies have found different results. Some of it might be due to cultural differences or the fact that OCD looks different at different ages. Many of the studies were done in different countries and looked at different age groups (children, teenagers, or adults). Culture might be an important factor that researchers haven't studied enough when it comes to OCD. Also, even though OCD is considered a long-term condition that usually starts early in life, it looks very different in children compared to adults. More research is needed to understand how culture and different life stages affect when OCD starts and how it changes over time. 

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